Predictors of Fear of Childbirth and Normal Delivery Among Iranian Postpartum Women: A Cross-Sectional Study

Abstract

Background: Fear of childbirth (FOC) may contribute to postpartum depression, impaired maternal-infant relation, and preference for cesarean in future pregnancies. The mode of delivery may have a role in postpartum FOC. We aimed to investigate predictors of FOC and normal vaginal delivery (NVD) among postpartum women who had planned for NVD. Methods: This cross-sectional study was conducted in 2019 on postpartum women during the first 24 hours after the delivery. A sample of 662 women, selected using convenient sampling method, filled out the questionnaire composed of socio-demographic and obstetric questions and the Wijma Delivery-Expectancy Questionnaire (W-DEQ). We used univariate and multivariate logistic regression analyses to determine predictors of FOC and NVD.Results: The percentage of women with mild (scores ≤ 37), moderate (38-65), high (66-84), severe (scores 85-99) and intense (scores ≥ 100) FOC were 7.9%, 19.5%, 40.9%, 21.1%, and 10.6% respectively. Predictors of severe FOC were a low level of satisfaction with husband’s support and a low level of satisfaction with pregnancy. Predictors of intense FOC were age < 30, primiparity, low maternal satisfaction with pregnancy, and a low level of perceived marital satisfaction. Overall, 21.8% of women gave birth by cesarean. Predictors of NVD were birth weight < 4kg, spontaneous labor pain, mother’s age < 30, term pregnancy, having a doula, multiparity, satisfaction with husband's support, and satisfaction with pregnancy. FOC was not a predictor of NVD. Conclusions: The rate of severe and intense FOC among this group of postpartum women is high. Our findings highlight modifiable factors for reducing FOC and increasing NVD. In designing programs to increase the rate of NVD, the following factors should be considered: limiting induced labor, encouraging women to recruit a doula to help them at labor, facilitate husband’s attendance throughout antenatal/intrapartum and postnatal care to support his wife, consultation with couples to increase husband’s support, and other steps to make pregnancy pleasant and memorable. According to our findings, factors that can contribute to the reduction of the rate of FOC were consultation with couples to increase husband support and marital satisfaction and also finding ways to make pregnancy a pleasant experience.

Predictors of low birth satisfaction among Iranian postpartum women: A cross‐sectional study

“…In women who eventually had a vaginal delivery, having a companion had a significant positive effect on birth satisfaction, but in women who had an emergency caesarean, it had a significant negative effect. This result is in line with previous studies that found that in normal vaginal deliveries, having a doula at birth improved maternal emotional well-being, reduced anxiety and fear of childbirth (McLeish & Redshaw, 2019;Mortazavi & Mehrabadi, 2021). In addition, evidence from other studies indicates that presence of a companion at birth is a predictor of childbirth experience (Khalife-Ghaderi et al, 2021) and increases the overall birth satisfaction (Mocumbi et al, 2019).…”

Predictors of birth satisfaction among Iranian postpartum women: a cross-sectional study

“…In women who eventually had a vaginal delivery, having a companion had a signi cant positive effect on birth satisfaction but in women who had an emergency cesarean, it had a signi cant negative effect. This result is in line with previous studies that found that in normal vaginal deliveries, having a doula at birth improved maternal emotional wellbeing, reduced anxiety and fear of childbirth [42,43]. In addition, evidence from other studies indicate that presence of a companion at birth is a predictor of childbirth experience [38] and increase the overall birth satisfaction [16].…”